RN Utilization Review – Part‑Time Day
Providence Holy Cross Medical Center in Mission Hills, CA is a four‑time Magnet® designated hospital, recognized for nursing excellence and high‑quality care.
This part‑time position consists of 8‑hour day shifts.
Role responsibilities:
Provide prospective, retrospective, and concurrent utilization reviews for LA ministries.
Conduct clinical reviews and review medical records daily during admission for all payers, as required by health plans.
Utilize strong clinical background combined with knowledge and skills in Utilization Management, medical necessity, and patient status determination.
Effectively manage a diverse workload in a fast‑paced, rapidly changing regulatory environment, demonstrating excellent negotiation, communication, problem‑solving, and decision‑making skills.
Required Qualifications:
Associate’s Degree – Nursing.
California Registered Nurse License upon hire.
Minimum 2 years experience working in a remote UR environment or as an acute hospital case manager.
Preferred Qualifications:
Bachelor’s Degree – Nursing.
Master’s Degree – Nursing.
Experience working with Interqual guidelines.
Experience in a multi‑hospital and/or integrated health care system.
Why Join Providence?
Our best‑in‑class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you so you can focus on delivering our mission of caring for everyone, especially the most vulnerable in our communities.
About Providence
At Providence, our strength lies in our promise of “Know me, care for me, ease my way.” We support your career, provide an inclusive workplace, best‑in‑class benefits, and foster diversity.
Requisition ID: 396717
Company: Providence Jobs
Job Category: Health Information Management
Job Function: Revenue Cycle
Job Schedule: Part time
Job Shift: Day
Career Track: Nursing
Department: 7000 UTILIZATION MGMT REMOTE
Address: 15031 Rinaldi St, Mission Hills, CA
Work Location: Providence Holy Cross Medical Ctr – Mission Hills
Workplace Type: On-site
Pay Range: $56.44 – $87.63 per hour (base pay; additional compensation may be available)
Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time‑off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well‑being resources, and more. Learn more at providence.jobs/benefits .
Applicants in the Unincorporated County of Los Angeles: Qualifying applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
We believe diversity makes us stronger; we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Seniority level: Entry level
Employment type: Part‑time
Job function: Health Care Provider
Industries: Hospitals and Health Care
Apply today to join our team at Providence Holy Cross Medical Center.